Organization Name: | COVENANT CARE FCH |
NPI Number: | 1114253564 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GAIL H PAYNE (ADMINISTRATOR) |
Mailing Address: | 515 Nottley River Rd. Murphy |
State: | NC US |
Postal Code: | 289067758 |
Phone Number: | 8288353605 |
Fax Number: | |
NPI Enumeration Date: | 10/20/2009 |
NPI Last Update Date: | 10/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | FCL-020015 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |